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Hipotensi terkendali pada reseksi tumor optic head meningioma

  • Andrian Yadikusumo ,
  • Putu Pramana Suarjaya ,
  • I Ketut Sinardja ,

Abstract

Optic head meningioma comprises 1-2% of meningiomas. An optic head meningioma undergoes tumor resection surgery was a challenging case to do intra and postoperatively. We found that controlled hypotension effective to produce a safe anaesthesia.1 35years old woman with Right Optic Head Nerve Meningioma. Preoperative assessment presented with proptosis, headache, vision loss, and remarkable ICP raising. Induction was achieved with TCI Propofol 3mcg/ml/minute, analgesia achieved from 200mcg fentanyl, and continuous drip of vecuronium. Controlled Hypotension achieved with 1mcg/kg clonidine. SBP controlled between 80-100mmHg to achieve 50-68 MAP. Slack brain achieved with 200ml Mannitol. Surgery time was 5hours with no hemodynamic alterations. Patient observed at ICU for 48hours, and discharged at 5thday. Controlled hypotension is to reduce SBP to get 50-65mmHg MAP. A slack brain would facilitate tumor resection more clearly.2 Controlled hypotension that safe for neurosurgery was at50-65mmHg MAP for 2hours. This is related with blood flow duration on neurologic function. Patient selection, careful monitoring, and adequate volume replacement are mandatories.1

References

  1. Barak M., Yoav L., Naaj I A., Review Article : Hypotensive Anesthesia versus Normotensive Anesthesia during Major Maxillofacial Surgery: A Review of the Literature. Hindawi Publishing Corporation The Scientific World Journal 2015;1 1 – 7
  2. Bruder N, Ravussin P. Supratentorial Masses. Dalam : Cottrell JE, Young WL (Eds). Cottrell and Young’s Neuroanesthesia. USA: Mosby Elsevier, 2010 : 184 - 202
  3. Eddleman, C. S., LIU, J. K. Optic Nerve Sheath Meningioma : Current Diagnosis and Treatment. Neurosurg Focus 2007; 23(5) 1-7
  4. Gurman G. M., Deliberate hypotension- what is for and what is against using it ? Israel : Ben Gurion University of the Negev, Beer Sheva, 2013
  5. Shailendra J., Ornstein E., Young W. L., Cerebral and Spinal Cord Blood Flow. Dalam : Cottrell JE, Young WL (Eds). Cottrell and Young’s Neuroanesthesia. USA: Mosby Elsevier, 2010 : 17 - 59
  6. Lalenoh D. C., Lalenoh H. J., Rehatta N. M. Anestesia Untuk Kraniotomi Tumor Supratentorial. Jurnal Neuroanestesia Indonesia 2012;1:1 16-24

How to Cite

Yadikusumo, A., Suarjaya, P. P., & Sinardja, I. K. (2018). Hipotensi terkendali pada reseksi tumor optic head meningioma. Medicina, 49(2). https://doi.org/10.15562/medicina.v49i2.57

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